Why ICBs Are Increasingly Using Bespoke Commissioning for Complex LD & Autism Placements

On 5 December 2025, NHS Cheshire & Merseyside Integrated Care Board published a notice relating to the transfer of care for three individuals with a Learning Disability and/or Autism who display behaviours that challenge. The notice appeared on Find a Tender as an F14 corrigendum — but crucially, it included no tender deadline and no invitation to compete.

For many providers searching for opportunities, this can be confusing. Why does a notice appear if there is no open tender? And what does this tell us about the direction of specialist commissioning for high-acuity LD & Autism services?

It’s Not a Tender — It’s a Corrigendum

The F14 notice type indicates that the publication is an amendment to a previously issued notice, not a new competitive opportunity. This is common where ICBs are commissioning services for individuals with significant clinical, behavioural or forensic risks.

In these cases, ICBs typically use:

• Existing provider frameworks (e.g., Supported Living, Complex Care frameworks)
• Closed Dynamic Purchasing Systems (DPS) where approved providers are pre-accredited
• Mini-competitions limited to selected providers
• Direct awards where continuity of care or urgency applies

This means the commissioning decision is made within an existing provider pool rather than through a public tender.

Why Bespoke LD & Autism Placements Rarely Go to Open Tender

For high-complexity cases, ICBs need to balance multiple factors including safeguarding, clinical input, community risk management and PBS capability. This makes open tendering impractical in many situations. Instead, ICBs rely on:

• Rapid decision-making when individuals require urgent discharge from restrictive settings
• High-trust relationships with proven specialist providers
• Known PBS and MDT capability within their commissioned networks
• Flexible commissioning pathways made possible by the Light Touch Regime

These bespoke arrangements form part of the wider Transforming Care commitment to move people with complex needs from inpatient settings into the community with the right support.

What This Means for Providers

Although these notices may not be open tenders, they provide valuable insight into market direction. Providers specialising in LD & Autism should take note of the following trends:

• ICBs are commissioning more individualised packages for 1–3 people at a time
• Clinical complexity is increasing, requiring robust MDT and PBS models
• Framework and DPS participation is now essential to access call-offs
• Mobilisation capability is a key differentiator for urgent transfers
• Governance and quality evidence is becoming more rigorous

In short: providers that are not on the right frameworks may never see these opportunities.

How to Prepare for Bespoke Commissioning in 2026

With the Procurement Act 2023 now active, we expect more ICBs to use flexible, staged procurement approaches rather than large open tenders. Providers should ensure they have:

• A clear complex-care service model tailored for Transforming Care
• Strong PBS leadership and training evidence
• Demonstrable MDT and clinical partnerships
• Rapid mobilisation plans for urgent step-downs
• Up-to-date framework applications and DPS registrations

Final Thoughts

This corrigendum notice is not a missed opportunity — it’s a signal of how the market is changing. High-acuity placements are increasingly being procured through targeted routes, closed competitions and framework call-offs. Providers that prepare now will be better positioned to secure these specialist packages in 2026 and beyond.

If you’d like support with complex care tender readiness, framework applications, or service model development, feel free to get in touch.